Pain, Part I: Signs of Pain

December 30, 2013

Because dogs and cats cannot communicate with us using language, their pain has traditionally been under-recognized and undertreated. In addition, it used to be a commonly-held belief that some degree of pain helped keep animals quiet and therefore prevented them from aggravating painful conditions or kept them quiet after surgeries. As our understanding of pain improves, however, we are becoming better at both recognizing pain in our pets and understanding the potential negative consequences of untreated pain, which among other things can include delayed healing – the opposite of what we used to believe!

Our pets can experience pain for the same reasons we can: Injuries, arthritis, infections, inflammation, or a wide variety of diseases as well as pain after surgery or other procedures. The pathways that carry pain through the body to the brain are similar in our pets and in people, so if something is painful for you it is a good bet that it is likely painful for your pet as well. Just like people, different individuals seem to have a different tolerance to pain and stress or fear can actually increase the perception of pain by the brain. This is important, because pain control will be better overall if we anticipate and pre-emptively treat situations that might cause pain (such as surgery)  in our pets rather than waiting until they act painful to treat.

In some cases, however, we cannot anticipate pain: Acute injuries, hidden diseases or infections, or arthritis. In those cases you need to rely on your relationship with your pet and knowledge of his/her normal behavior and be observant for changes. The following is a list of signs you might see if your pet is feeling painful; keep in mind, however, that every animal is an individual and you may see only one or two signs and which signs an animal shows may vary greatly from pet to pet. It is unlikely you will see them all. In addition, our pet dogs and cats still have some of their wild instincts to appear as normal as possible for as long as possible because in the wild an animal who is not acting normally is vulnerable to competitors and predators. This means that the signs that you see may be very subtle or only seen at certain times of the day.

Vocalizing (whining, howling, grunting, groaning): This is more commonly encountered with acute pain such as injures or post-surgically (when anesthesia may also cause vocalization). In more chronic conditions such as arthritis it is relatively uncommon or may occur only when trying to perform specific actions (such as a dog with painful hips grunting when trying to get up from lying down) or when frustrated by not wanting to do some normal activity (such as a dog standing at the bottom of the stairs whining).

Activity, Habits and Behavior: Look for changes from what is normal for your pet.

1. Restlessness, repeatedly changing position or seeming unable to find a comfortable position
2. Refusing to do previously normal activities (stairs, jumping on counters or furniture)
3. Stopping/balking on walks
4. Difficulty lying down, or getting up from sitting or lying down
5. Visible stiffness or limping
6. Gait looks different when moving, even if you can’t quite put your finger on what has changed
7. Sleeping more, not getting up to greet you when you come home or follow you around the house
8. Repeatedly stretching, yawning, or pacing
9. Any major behavior change
10. Changes in interaction, either withdrawing (more commonly cats) or becoming more “clingy”
11. Suddenly becoming irritable, snappish, hissing, or aggressive
12. No longer tolerating previously enjoyed activities such as being brushed or petted
13. Suddenly not tolerating being touched in a certain way or on a certain body part
14. Excessive panting at rest and when cool (dogs)
15. Eating, drinking less
16. Changes in litter box use or housetraining
17. Changes in appetite
18. Abnormally easily spooked or startled
19. Obsessive licking, grooming, biting, or chewing a particular body part
20. Sudden obsession with drinking excessive amounts of water

Appearance and Posture:

1. Poorly groomed, scruffy coat (especially cats)
2. Hunched or leaning forward or backward when standing (especially dogs)
3. Holding head level with spine when standing (especially dogs)
4. Head bobbing up and down excessively when trotting or running (dogs)

This list is not all-inclusive, and several of them may be associated with conditions other than pain.. The key is to look for changes in your pet’s normal behavior. If you have any questions about whether your pet may be painful, please call the clinic to speak to a doctor.

Future posts on this topic will include a discussion of how pain works and options for treating various sources of pain, so stay tuned to this space!